Superior mesenteric artery is more important than inferior mesenteric artery in maintaining colonic mucosal perfusion and integrity in rats

Mucosal hemodynamics (by reflectance spectrophotometry) and mucosal damage (by histologic examination) following acute colonic ischemia were evaluated in different anatomic locations in the colon of anesthetized rats. The reflectance spectrophotometer provides an index of mucosal hemoglobin concentration (IHB) and an index of oxygen saturation of hemoglobin (ISO₂). The patterns of ischemia without congestion (IHB, ISO₂) during superior mesenteric artery occlusion, and ischemia with congestion (IHB, ISO₂) during portal vein occlusion, previously demonstrated in the stomach and duodenum, are also applicable to the colon. The significant linear correlations between changes (as percent of baseline) in IHB, ISO₂, and hydrogen gas clearance suggest that changes in these indices are adequate indicators of changes in colonic mucosal perfusion. Superior mesenteric artery ligation produced significant reductions in both indices, and an increase in damage in the mucosa of the cecum, transverse colon, splenic flexure, and left colon, but not the rectum. Inferior mesenteric artery ligation produced only slight reduction in these indices and minimal damage only in the mucosa of the splenic flexure. These results support the hypothesis that the superior mesenteric artery is more important than the inferior mesenteric artery in maintaining colonic perfusion and colonic mucosal integrity in the rat.Supported by the American Society for Gastrointestinal Endoscopy Career Development Award (H850208, H870212), Veterans Administration Medical Research Funds; and in part by research grants (0162-01, 0162-02; 0291-01) from the Smokeless Tobacco Research Council, Inc.; and by funds provided by the Cigarette and Tobacco Surtax Fund of the State of California through the Tobacco Related Disease Research Program of the University of California.     

Oculomotor and vestibular anomalies in Pelizaeus-Merzbacher disease: a study on a kindred with 2 affected and 3 normal males, 3 obligate and 8 possible carriers.

Two males suffering from Pelizaeus-Merzbacher disease were examined, one at the age of 1 year 4 months and at the age of 7 years, and the other at the age of 7 years 8 months. The former had spontaneous vertical pendular nystagmus. He also showed horizontal "micronystagmus", present only at the age of 1 year, which might be similar to "voluntary nystagmus". Both males had jerky bilateral gaze-evoked nystagmus, defective smooth pursuit and optokinetic responses and a hyporeactive vestibulo-ocular reflex (VOR). All three obligate carriers exhibited typical VOR disinhibition in the two horizontal nystagmus directions, which may be a distinctive feature. This feature was also found in one of the 7 possible carriers examined and was not observed in the 3 non-affected males, who had normal oculomotor responses.     

The use of quinacrine (Atabrine) in rheumatic diseases: A reexamination

Atabrine has been available for nearly 60 years. It has a variety of actions and has been administered to millions of individuals. Its antirheumatic properties have been well documented but have not been exploited optimally for a variety of reasons. The drug is generally quite safe and could be used in low doses in lupus and rheumatoid arthritis patients as a steroid-sparing agent or synergistically with hydroxychloroquine. Its bothersome side effects should not deter the clinician from using it, because they are easy to deal with or prevent (Table 5). Future studies should attempt to better characterize the immunosuppressive actions of this powerful drug, particularly in the treatment of lupus erythematosus and rheumatoid arthritis. Studies of the role of combination or single-agent antimalarial therapy in combination with other "remittive" drugs could be of great potential benefit.     

Play interview therapy: Its history,theory and practice — A fifty year retrospective account

The method of the play interview offers the fearful child an opportunity to express himself by speaking for a series of dolls representing siblings, parents, teachers or himself. It is not the child who is aggressive, fearful, jealous or desires the parent's affection, but the doll. In this manner, the child learns to make connections between his fears and his unacceptable bad thoughts, feelings or wishes. Improvement occurs after several play interviews.This article is dedicated to Dr. Leo Kanner (1894–1981), former Director of the Children's Psychiatric Service of the Johns Hopkins HospitalLecture given to the Division of Child Psychiatry, Department of Psychiatry and Behavioral Sciences The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, Md, 21205, on September 6, 1988.     

Patterns and correlates of psychiatric hospitalization in a nationwide sample

Summary A nationwide random sample of psychiatric patients (n = 832) admitted for hospitalization in Israel in 1980 was followed up until the end of 1984 regarding their hospitalization patterns. Information about hospitalizations as well as demographic and diagnostic data were obtained from the Israel Central Psychiatric Case Register. Two main contrasting patterns of hospitalization emerged. One pattern consisted of a single short hospitalization during the entire follow-up period. This pattern was found among more than 50% of those patients for whom this hospitalization was the first in their life. The second pattern characterized the patients who accumulated long periods of inpatient stay, that is, at least one year during the follow-up period. These are the new chronic patients (about 30% of the total sample). About one third of these new chronic patients (8.2% of the total sample) accumulated their long stay through one continuous hospitalization, thus resembling the old chronic patients; two-thirds accumulated their long stay over several hospitalizations. Each patient has a fairly constant pattern of hospitalization, regarding the length of stay in hospital and out of hospital.     

Surgery in Jehovah’s Witnesses

This is a retrospective study of the outcome of surgical procedures in patients who were Jehovah's Witnesses. Over a 75-month period, 58 Jehovah's Witness patients had 78 surgical procedures at the Vancouver General Hospital. Three patients had preexisting anaemia of less than 100 g.L-1 haemoglobin. Postoperative haemoglobin concentration decreased below 50 g.L-1 in three patients. One patient had a postoperative haemoglobin of 34 g.L-1 (haematocrit 10.1 per cent) and survived. One patient died from uncontrollable postoperative haemorrhage. Perioperative morbidity was not uncommon, including significant hypotension (eight cases), cardiac arrhythmias (six), myocardial ischaemia (three), excessive bleeding (four), postoperative nausea or syncope (four), and wound or urinary tract infection (four).     

Radiological images on personal computers: Introduction and fundamental principles of digital images

This series of articles will explore the issues related to displaying, manipulating, and analyzing radiological images on personal computers (PC). This first article discusses the digital image data file, standard PC graphic file formats, and various methods for importing radiological images into the PC.     

A Decline in C6 Antibody Titer Occurs in Successfully Treated Patients with Culture-Confirmed Early Localized or Early Disseminated Lyme Borreliosis

C₆, a Borrelia burgdorferi-derived peptide, is used as the antigen in the C₆-Lyme disease diagnostic test. We assessed retrospectively whether a fourfold decrease or a decrease to a negative value in anti-C₆ antibody titer is positively correlated with a positive response to treatment in a sample of culture-confirmed patients with either early localized (single erythema migrans [EM]; n = 93) or early disseminated (multiple EM; n = 27) disease. All of these patients had been treated with antibiotics and were free of disease within 6 to 12 months of follow-up. Results show that a serum specimen taken at this time was either C₆ negative or had a ≥4-fold decrease in C₆ antibody titer with respect to a specimen taken at baseline (or during the early convalescent period if the baseline specimen was C₆ negative) for all of the multiple-EM patients (P < 0.0001) and in 89% of the single-EM patients (P < 0.0001). These results indicate that a decline in anti-C₆ antibody titer coincides with effective antimicrobial therapy in patients with early localized or early disseminated Lyme borreliosis.